目的探讨基层医院施行精准肝切除的可行性。方法回顾性分析临沧市人民医院2013年1月至2017年12月施行肝切除术的392例患者的临床资料,其中行精准肝切除术220例,非解剖性肝切除术172例,对2组患者的术前评估、手术规划、手术操作、术后管...目的探讨基层医院施行精准肝切除的可行性。方法回顾性分析临沧市人民医院2013年1月至2017年12月施行肝切除术的392例患者的临床资料,其中行精准肝切除术220例,非解剖性肝切除术172例,对2组患者的术前评估、手术规划、手术操作、术后管理及围手术期治疗、术中出血量、术后住院时间、肿瘤及结石复发率等进行总结分析。结果全组均完成手术,两组平均术中出血量、平均术后住院时间、胆汁漏发生率分别为,精准组(574.5±50.6) m L、(17.4±2.1) d、1.8%(4/220),非解剖组(894.6±55.7) m L、(25.2±3.6)d、 3.5%(6/172),2组比较有显著性差异(P<0.05),精准组优于非解剖组。手术时间、术后出血、多重耐药性感染率、肝周包裹性积液及术后肝衰竭发生率比较无显著性差异(P>0.05)。术后354例获随访(其中精准组201例,非解剖组153例),随访时间1个月至4 a,术后1 a、3 a无瘤生存率分别为,精准组79.6%(109/137)、50.4%(69/137),非解剖组56.8%(63/111)、37.8%(42/111),结石复发率分别为,精准组3.1%(2/64)、非解剖组19.0%(8/42),2组比较,差异有统计学意义(P<0.05),精准组优于非解剖组。结论精准肝切除具有术中出血少、术后住院时间缩短、患者术后无瘤生存率提高和结石复发率低的优势,在基层医院实施也能取得满意的效果。展开更多
The transmission performance of cycloid ball planetary transmission(CBPT) is affected by cycloid tooth undercutting directly, and the design of CBPT can be optimized by the non-undercutting condition. Firstly, the the...The transmission performance of cycloid ball planetary transmission(CBPT) is affected by cycloid tooth undercutting directly, and the design of CBPT can be optimized by the non-undercutting condition. Firstly, the theoretical equation of cycloid tooth is given, and the curvature radius of cycloid tooth profile is derived. Secondly, according to the relationship between the curvature radius and the distribution circle of balls, the non-undercutting condition of cycloid tooth profile is established, and the non-undercutting critical condition is deduced. Finally, the validity of the non-undercutting critical condition is verified by simulation. The result shows that the non-undercutting critical condition can be used to optimize the design of CBPT.展开更多
文摘目的探讨基层医院施行精准肝切除的可行性。方法回顾性分析临沧市人民医院2013年1月至2017年12月施行肝切除术的392例患者的临床资料,其中行精准肝切除术220例,非解剖性肝切除术172例,对2组患者的术前评估、手术规划、手术操作、术后管理及围手术期治疗、术中出血量、术后住院时间、肿瘤及结石复发率等进行总结分析。结果全组均完成手术,两组平均术中出血量、平均术后住院时间、胆汁漏发生率分别为,精准组(574.5±50.6) m L、(17.4±2.1) d、1.8%(4/220),非解剖组(894.6±55.7) m L、(25.2±3.6)d、 3.5%(6/172),2组比较有显著性差异(P<0.05),精准组优于非解剖组。手术时间、术后出血、多重耐药性感染率、肝周包裹性积液及术后肝衰竭发生率比较无显著性差异(P>0.05)。术后354例获随访(其中精准组201例,非解剖组153例),随访时间1个月至4 a,术后1 a、3 a无瘤生存率分别为,精准组79.6%(109/137)、50.4%(69/137),非解剖组56.8%(63/111)、37.8%(42/111),结石复发率分别为,精准组3.1%(2/64)、非解剖组19.0%(8/42),2组比较,差异有统计学意义(P<0.05),精准组优于非解剖组。结论精准肝切除具有术中出血少、术后住院时间缩短、患者术后无瘤生存率提高和结石复发率低的优势,在基层医院实施也能取得满意的效果。
基金Funded by the National Natural Science Foundation of China(Grant No.51405003)
文摘The transmission performance of cycloid ball planetary transmission(CBPT) is affected by cycloid tooth undercutting directly, and the design of CBPT can be optimized by the non-undercutting condition. Firstly, the theoretical equation of cycloid tooth is given, and the curvature radius of cycloid tooth profile is derived. Secondly, according to the relationship between the curvature radius and the distribution circle of balls, the non-undercutting condition of cycloid tooth profile is established, and the non-undercutting critical condition is deduced. Finally, the validity of the non-undercutting critical condition is verified by simulation. The result shows that the non-undercutting critical condition can be used to optimize the design of CBPT.
